• Dental is covered by CLASS as a sub-category of the Adaptive Aid category.
  • This means that the CLASS annual limit of $10,000 allowed for Adaptive Aids includes dental costs + adaptive aid costs.
  • The service is paid for through your CLASS Direct Service Agency.
  • This is covered in CLASS Provider Manual Appendix IV.

Participants under 21 years old:

• Dental is covered by Medicaid acute care and is not a benefit of CLASS at this age

Participants over 21 years old:

• Dental is not covered by Medicaid acute care, but some STAR+PLUS MCOs have a Value-added benefit to cover a small amount of dental.
  • UnitedHealthcare – $500/year
  • AmeriGroup – emergency only
  • Molina – emergency only

Steps to request and access CLASS dental funds:

1. Request that your Case Manager put $200 in your CLASS budget for a dental evaluation. CLASS allows this dental money to be authorized without additional documents.
   • If you have private insurance that will cover this evaluation, you can skip Steps 1-4.
   • Save time and ask your Case Manager to include $200 at each annual budget meeting after you turn 21 years old! Then you can jump to #5.
   • Save even more time by having your dentist make the treatment plan for next year at the last visit of this year!
2. Your Case Manager will complete the budget change, send it to you to sign, and provide Form 3660 to start the process of requesting dental through CLASS.
3. Return the signed budget and Form 3660 Part A to your case manager.
4. Your Case Manager will submit the budget and it will be effective in 30 days.
5. Once you are notified by your Case Manager that the CLASS budget has been approved, make an appointment for the dental evaluation at the office of your choice.
   • Confirm that this initial visit will cost $200 or less.
   • Notify your DSA with the date of the initial appointment and contact information for the office, so the DSA can provide instructions on billing and a guarantee of payment to the office.
6. Go to the dental evaluation with Form 3660 page 2.
   • Request that the dentist fill and sign Form 3660 Part C to justify your need for this treatment plan
   • Request that the dental office create a treatment plan outlining the maintenance visits and any treatments needed between now and the end of your CLASS budget year.
     • Do you have private dental insurance? If so, the treatment plan needs to include a column of the cost that will be covered by that insurance and a column of what will need to be paid by CLASS.
7. Send Form 3660 page 2 + the treatment plan to your DSA.
8. Your DSA will complete Form 3660 Part D and send a request to your Case Manager to add funds to CLASS budget.
9. Your Case Manager will complete the budget change and send it to you to sign.
10. Return the signed budget to your case manager.
11. Your Case Manager will submit the budget and it will be effective in 30 days.
12. Once you are notified by your Case Manager that the CLASS budget has been approved, funds will be available when needed throughout the year
13. Each time you make an appointment for an item on the dental treatment plan, notify your DSA of the appointment date. This will give them time to communicate with you and the dental office if needed.

Annually, ideally 60-90 days before your new CLASS budget starts:

1. Give Form 3660 page 2 to your dentist.
   • Request that the dentist fill and sign Form 3660 Part C to justify your need for this treatment plan
   • Request that the dental office create a treatment plan outlining the next CLASS budget year.
2. Send Form 3660 page 2 + the treatment plan to your DSA.
3. Your DSA will complete Form 3660 Part D and send a request to your Case Manager to add funds to your new CLASS budget.
4. Sign Form 3660 Part A as part of your annual budget meeting.
5. Your Case Manager will include this in the CLASS Renewal Budget…
6. Then the money is ready when your new year starts!

Notes for the dentist:

Since CLASS HHS doesn’t issue a dental fee schedule like an insurance company would, it can be challenging to know if CLASS HHS will approved items on a treatment plan.

But here are Information Letters issued by HHS on this topic – share them with your dentist!

• HHSC Information Letter No. 19-04: Recommendations for Dental Treatment Plans

Dentists recommended by some of my clients:

Dentist/Office Name	Sedation Dentistry	Website	Phone	Address
Dentistry for Children + Bay Area Specialist (for adults)	Yes	dds4childrenpearland.com	(281) 317-6886	505 S Friendswood Dr. #209 Friendswood, TX 77546
Heather Wilmore	Yes	drwilmore.com/sedation-dentistry	(713) 266-4222	7500 San Felipe #900 Houston, TX 77063
Hospital Sedation Dentistry	Yes, in hospital	markstephensondds.com	(936) 760-2200	500 Medical Center Blvd #110  Conroe, Tx 77304
Texas Children’s Hospital Dental and Dental Surgery	Yes, in hospital	texaschildrens.org/departments/dental	(832) 822-3200
Houston Children’s Dental Center	Yes, in surgery center	bluecloudpsc.com/location/houston-childrens-dental-center/	(713) 944-7700	3800 North Shepherd Dr #B Houston TX 77018
Caldwell & Steinbring – Dentistry For Children	Yes	larrycaldwelldds.com/patient-info/special-needs-patients	(281) 565-5437	15200 S.W. Freeway #320 Sugar Land, TX 77478
James Stamper	Yes, in hospital	dentists4kids.com/find/james-stamper/	(281) 495-8828	12000 Wilcrest, #207 Houston, TX 77031